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that is connected relapse. relapse is this, this horrible place that once you fall down, that sometimes you don't get up from. so that's a way that we can work with the treatment system. you know and i also think that, that this, we're presenting really a moving target if you will. it's probably what you would call the flavor of the month syndrome and that also language is open to interpretation, like prevention is somebody in the field would probably mean something that's, evidence-based practice. but if you talk to a community person, prevention would be keeping the recreation center open for hours. we talk of things like paradigm shift or transformation. and all of these terms we use, so we have co-occurring, we have substance use disorder, we have substance abuser, we have chronic illness, we have disorder. and i, i think it's confusing, it's confusing to the field itself and, and sometimes we, we fall into this trap where we think language is interchangeable, and i think it causes more harm than good.
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you know, you've hit on something that i have observed over the last 13 years that i've been at samhsa and, and that is that just when you get comfortable using one terminology, along comes someone else and then they find, particularly not only in the substance use disorder field, but also in the mental illness field. right, john, i mean it's, it's just you know as difficult as we find the, the subject matter in, in the substance use disorder field, you know the mental illness side also presents with, i think, some similar circumstances. for sure. when you think about other disorders, for example, the thought, the one, the disorder comes to mind quickly when, as a first cousin of substance abuse disorder are eating disorders. now when you talk about eating disorders, we always, invariably, people use the term inside, outside of the field, they refer to it as an eating disorder, not as food abuse or, and don't refer to them as food abusers.
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and that has grown up just in, in a very consistent fashion. it's always been eating disorders, as far as i can remember it, it's never been anything else. and i've never heard the term food abuser, even, and so it has, there are models for this kind of terminology which seem to be palatable, acceptable to most people, when you're talking about food. but when it comes to substances, of course, we have this abuser term, somehow has gotten into the language and culture and becomes very difficult to shift. and if i could just mention how this may be actually unconscious and the effects of it may be unconscious is that we did a study where we randomly assigned the term abuser, substance abuser and substance use disorders. we had those two terms and these were mental health practitioners, many of them were doctoral level, 500 and, over 500 clinicians doing this study.
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and they had a vignette which described someone with a substance related problem and the, the vignettes were identical except for the term used. so half the subjects got the vignette describing the individual as a substance abuser and half of them, half of them got the individual described as having a substance use disorder. and then they were asked a number of questions about whether they perceive this person, needed treatment versus should be punished, whether they had sympathy for the person, whether they were able to control their problem, so this kind of issue of self-regulation, whether they thought they were personally to blame for the situation for the problem that they had. and those who were assigned the substance abuser condition were more likely to have more punitive attitudes than those who had the substance abuse disorder condition. and these were, these were doctoral level, most doctoral level mental health clinicians. so it may be that even unconsciously it triggers a bias that people aren't even aware of.
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i think this is very important because even though we may use the term ourselves, thinking well, i don't mean it like that, i mean it like this. i mean in a more general sense and i certainly don't mean it in a stigmatizing way. but what can be conveyed and picked up, unconsciously perhaps, is that it does evoke, elicit, these more punitive attitudes towards these individuals. and when we come back, we're going to continue to chat about that and i think we need to get into a dialogue about how we can change this. we'll be right back. [music] it's important to be familiar with the proper terminologies surrounding addiction and recovery.
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one of the terms you'll want to be familiar with is, discrimination. discrimination is treating someone less favorably than someone else because he or she has, once had, or is regarded as having a disability. for more information on this and other recovery jargon, visit the recovery month website. people who suffer from drug or alcohol addiction, sometimes say hurtful things. they drive the people who love them most, away. if you know someone who suffers from drug or alcohol addiction, listen, try to hear what they are really saying. know that there is hope and help them find their voice again. for drug or alcohol treatment referral for you or someone you know, call 1-800-662-help. brought to you by the us department of health and human services. they tell me i was there but i don't remember. i don't know where i really was.
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i do not know what i had for breakfast. i do not know who won the game. i don't recognize this man. if you or someone you know is struggling with a drug or alcohol problem, there is a solution: recovery. call 1-800-662-help for information and for hope. through treatment my life's a whole lot brighter now. brought to you by the us department of health and human services. [music] language is such an important part of
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communicating with people what addiction, mental health disorders and recovery is all about. a lot of people have stereotypes about what these, what these disorders are all about and they're not accurate. and so using language can really help people understand what those disorders are about, what they mean, and how people are living successfully in recovery today. [music] our stories have power was the training that was developed by faces and voices of recovery in conjunction with funding from samhsa. people in the recovery community have been looking for a long time for language that they can use to really describe what it is that they've been through and what it is that they're trying to advocate for. so faces and voices of recovery has used the training as an opportunity create a video, a dvd,
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that can be you know sent around the country, can be put on the internet, can really be used in trainings and in workshops around the country so that more people have the terminology that's necessary to communicate our, our message to the broadest possible audience. there are three major sections of the dvd. the first is a 90- minute training video which takes you through faces and voices of recovery's media and message training, the actual core training itself. the second part of the dvd is a section called, "keys to successful interviews". that section really is helpful for people who are going to be going into an interview situation and they need to brush up on some basic skills. and the third section of the dvd contains all the materials, the powerpoint materials, our message training, our tips on successful media interviews, that folks can use to further their
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skills as they go along through this training. you have recently gotten involved with faces and voices of recovery, laura, tell me why you got involved with faces and voices of recovery and why you, what brought you to this work? i am so thrilled to be part of this organization, i'm really proud to be part of it. they have a message that is very near and dear to my heart, which is sharing the message of hope and recovery, to having a new way of life. i took away from the messaging that i attended last fall, that there are right words to use and, and not so good words to use. for example, we want to talk about recovery, we don't want to talk about addiction. addiction is where people are stuck in the problem. recovery is where people get into the solution and that's what it's all about, giving people hope and healing and a new way of life. some of the main questions that we receive is, what kind of training is this, you know? and when you say, media message training, that means that if the media... put a microphone and camera to my face and say,
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joe, i heard that you used drugs and alcohol before. and who are you? and how do i respond to the media and how do i respond to where the community and the public can know that the benefits of long-term recovery? i think the main message there is that people in long-term recovery can move onto advocate for people with addictions and people to also get long-term recovery like they did. the message is real clear that the benefits of recovery, it works, and that's a reality for many people that's in recovery today. lureen you wanted to comment. yeah, i really wanted to comment on something that, that carlos said and connected to what john was saying. carlos talked about the confusion around the language and john talked about the research that really showed how using strength-based language, how it impacts the person. and i think that there is this flavor of the day language.
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i mean we, you know, chemical dependency, it's always something different. but i think there's an opportunity here for us to really show the leadership because i think the difference is, is that this language that we want to promote, is actually something that's going to help people, it is the right thing to do. so i think rather than it being this floating, flavor of the day, that we actually have to take the leadership and make sure that people are using language that is going to promote this culture of recovery. but particularly now, i think with the healthcare reform, daphne, do we have an opportunity here in order to, to really turn things around? we have a huge opportunity here. the country is talking about healthcare reform, the country is talking about health and this is time to take this, this issue out of the crime pages and into the health pages. this is a health issue and when we begin to understand that, fundamentally in our own hearts from the, from academia to clinicians to
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the folks working in our prisons and jails, to understand that we are talking about individual health. this is a gigantic opportunity and it's, it's a wonderful opportunity because this changes the way people see themselves. when you come, a lot of people who have suffered with addiction, suffer from just horrible feelings of, of inadequacy...shame. ...shame, isolation and so forth. and when you learn that this is actually something that you have an ability to begin to treat, that other people have overcome themselves, that this is about health. and when you can move from saying, i feel sick to i feel well, as opposed to i, going from i feel you know i'm a bad person to a good person. we're talking about moving from sickness to health. so yeah, it's a great opportunity. and i'd, i'd like to mirror daphne's comments. i'm really, really excited about national healthcare reform,
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but i also feel that it's wrought with pitfalls because i believe we're going to interject a whole new set of language into the conversation, if you will. did a lot of organizing around the parity act and making sure that substance abuse was included in the language and the wellstone... substance abuse? yes, because it was the wellstone mental health parity act, so...substance abuse? am i hearing, substance abuse? yes ma'am, yes ma'am, yes ma'am. and, and you know daphne has, has quoted bill white quite a bit and, and he's truly prolific writer and agree with the title that folks had given him, the dean of recovery. but he was saying that three ways to deal with social stigma, stigmatations stigma, stigma if you will. one is to protest stigma and discrimination are illegal and you need to protest, protest that and bring it to the forefront and hold the folks that are doing it, accountable. but there also is an educational component he talks about.
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and then there's a contact component. and this this is not new. i got this from a 2009 paper that he did with arthur evans. and so i think you had suggested it, we need a multi-prong approach where stigma is alive and well and where folks are comfortable with that, we need to hold them accountable. but we need to do some education as well, within the field as well as outside the field. and then i think we need to look at establishing new contexts and reaching out to non-traditional groups if you will, the recovering community. i believe that we could do more in reaching out to them. and i think that is, that is i tell you, i have been through national alcohol and drug addiction recovery month and its events and the testimonials that we see from individuals in recovery. and it's almost painful to see what daphne was saying in terms of a shamed-based approach to, to their recovery. and it, it really, i think it's, it's an area where folks in recovery are going to have to work with
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other folks in recovery to, to bring them along to a comfort level where individuals can then be free of that self-perception, in order for them to change their language. do you agree, john? i do, i do, absolutely. i think this issue of stigma which is directly obviously connected to the terms that we use, is, is very important. i was just thinking about the, the world health movement, this is a not a us phenomenon either, it's, it's cross-national. the world health organization did a study in, in the late '90s across 14 different countries, looking at 18 of the most stigmatized conditions, including drug and alcohol addiction. so they had things like being homeless, being a criminal, being hiv- positive, all these very heavily stigmatized conditions. and what they found, cross-nationally, drug addiction was number one, alcohol addiction was number four, so two of the top four were the most
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stigmatized conditions cross-nationally. and stigma, and, and that surprised me. i mean obviously we all know that these conditions are very stigmatized, just how stigmatized, i didn't realize, that they, they would come top of that list. so that was very surprising to me. so what we're dealing with is possibly and probably the most stigmatized of all social problems, if you frame them, put it in that framework. and i think importantly, there were two factors that i see moderate stigma. one is cause and the other is controllability. cause being, it's their fault. controllability, they can't help it. so it is those two factors. and i think that science now has contributed to our understanding that people with a substance use disorder, they may have had the initial choice to pick up alcohol or another substance, but it's not their fault that they become addicted. and this is something that's been, been around for a long time.
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but it eludes most of us, i think, most of the time. and the other thing is controllability. science is now, as i mentioned earlier, helped our understanding in, in terms of people's inability, the impaired control which we know is an essential, perhaps the essential characteristic of addiction, is this inability to control, this impaired control over, over use despite harmful consequences. and so this issue of cause and controllability and the science that's, that's really informed that, have really helped i think to de-stigmatize. and we need to get that message out that these are health problems to, that they are treatable. they are probably the most, have the best prognosis of any mental disorder on the severe end of the spectrum. most people eventually recover from a substance use disorder and these are the kinds of messages because i think out there, there's a lot of kind of negative thinking and nihilism regarding the,
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the prognosis for individuals with addiction, they're, they're hopeless. there's no chance, we can't help them and, and they lie all the time and, and these kinds of very biased statements which sorry you were going to say? it was fine. i just wanted to say that when we come back, i want to get into the, the notion of how do we sustain a, a conversation of holding folks to be responsible in a way that doesn't stigmatize or doesn't discriminate? because if we, if we need to look at things differently, then we need to substitute that which we think now, with something more positive and, and we need to learn how to do that. we'll be right back. for more information on national alcohol and drug addiction recovery month events in your town, and how you can get involved, visit the recovery month website at
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[music] people trapped by drug or alcohol addiction often feel like there's no hope. no way out. but for every lock, there's a key. and if you have a problem it's good to know there are real solutions to help you get free. for drug or alcohol treatment referral for you or someone you know, call 1-800-662-help. brought to you by the u.s. department of health and human services. people who suffer from drug or alcohol addiction sometimes say hurtful things. they drive the people who love them most away. if you know someone who suffers from drug or alcohol addiction-listen. try to hear what they are really saying. know that there is hope and help them find their voice again. for drug or alcohol treatment referral for you or someone you know call 1-800-662-help.
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brought to you by the u.s. department of health and human services. [music] hi, i'm michele monroe with the road to recovery and we're here today in maryland getting some opinions on what people think about different languages used in the substance abuse and mental health arena. if i said that somebody had a drug and alcohol addiction what would you think that that means? i think the person has a... a certainly health issue problem that needs to be, needs to be attended to. i would think of people struggling in difficult circumstances... with certain underlying issues that, that lead them to feel that they need to use those things as an outlet. i think of a illness, i think of a sickness that's hard to overcome. and i think that the person needs support,
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as much support as possible. i think about people who needs help and they need to find help as soon as possible. so what if i said alcohol and drug problem? what do you feel about that? it's a problem that needs to be fixed, that's what i start thinking, you know, and you need to fix it, you need to find a way to fix it. if there needs to be out there more programs for these people, more resources where they can get to as soon as possible, you know, where they can speak their languages cause alcohol doesn't have any color or any face, any language. it comes in any, it can be anybody. and then problems sounds like, you just, you can deal with it if you seek for help, then addiction sounds more like you are in serious problem. i think it's the same thing, i mean i think that if you have an addiction, you have a problem. you know, if you have a problem, you could possibly have an addiction. so the same thing goes you know, they need help, they have an illness and they need support.
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if i told you i was in recovery, what does recovery mean to you? i, i think you're really trying to get, get back on the right track and, and i would certainly pray for you and hope that you could stay there and get better because recovery is very difficult you, first of all you have to admit that you need the recovery. and then when you recover, it takes, it's a long process. i think when a person says that they are in recovery and they're trying to get over their addiction, one must give them a chance and believe them. recovery to me is a first step, just because you're in recovery, that doesn't that mean that you're going to be recovered completely. so, but it's the first step for you to get to where you need to get to be able to say, i used to be that. if, if you're telling me that you're in recovery, i'd say that you are trying to get your life together and that you have a serious problem and that you're, you care about becoming a better person. somebody was trying to get into recovery and needed treatment and needed help. do you have a role in their recovery? and if you have a role, what role do you think you would need to play?
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i've been taught that that the whole family as well as the community plays a role in your recovery, so. i think you really have to love them and help them through it and don't prosecute them and make them think that they're doing something wrong and, and give them support. if the person is open to letting you help them, just really being there to support them, you know, give them that emotional support that they need. i do have a role, i think people whose, you know, seeking for help, they do need support from others because obviously they cannot cope by themselves with the issues they may have. so i guess my role will be like just be there and supportive and try to be a friend and understand what they are going through. i'd probably just want to like speak into their life as much as possible and try to encourage them that i think realization for them is the most important to realize that they have an addiction problem and
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then to go about trying to help them through recovery and being as supportive as possible in the process. do you think recovery is possible and that people can make a change? it would be hard, it's very hard, but it's possible. anything's possible. i absolutely think recovery is possible and it's, it's something different for each person, but it it's probably a long process and will take a lot for them to be able to recover. recovery is definitely possible, where there's a will, there's a way, so everybody who really wants to recover, i believe they can recover, but they just have to really try. yeah, i think you can recover. i mean, like a lot of it depends on environment, like you got to get away from what you're doing and, and you know if you want to, if you want to do it, you can. so daphne, how do we change the paradigm? how do we begin to use positive language, person-centered, people- first type of language? we begin by being conscious of the words that we're using and there are a number of words and
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papers and reports and so forth out there that promote words like health and recovery and person-centered and mutual support and so forth. and so there's a, there's a model that talks about going from unconscious incompetence at something, where you, where you do something and it's not what you want to do but you're not even aware of it, to conscious incompetence where you begin to be aware that these aren't the terms i want to use, to conscious competence and we're starting to be more aware of the terminology we're using to unconscious competence. and i think that's what we want to do as a field, is move to a point where we're automatically speaking in positive, person-centered, health-centered approaches. you two folks are in recovery. now they're going to be folks out there that are going to say, alright, based on what john was saying, how do you then hold the person
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responsible for their need to keep themselves in the straight and narrow, even thought they may have had a, a recurring need for treatment? how do we then begin to reshape that to still not be offensive but to get our...a point across? well i, i really connected to what you're saying, i really want to comment on what daphne was saying. i think that we have to demand that people begin using the right language and there's a very simple and easy and concrete way to do that. one of the things that i've noticed is that people are not adapting the new language, but they're still being supported in certain ways. whenever someone has to write an rfp for something, they need to be using the correct language. i, i've seen rfps that have been written and i can see by the language that's being used, that they are not, they're not moved to this whole framework of recovery, but they're still being awarded.
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so we need to help people to begin to use, and if we do that, they're going to pick it up immediately because people need, organizations need funding. i believe samhsa has done a great job in, in laying the framework for, if you will, for the type of discussion that i think needs to happen. and i think it's around recovery in a system of care model that's person-centered and it's based more on the holistic approach. that it's, it's person-driven if you will. and i, i think we just to build upon that. i think that's the way we begin to have the kind of conversations where all of a sudden, instead of 200,000 recovery advocates, you're making greater head roads into the 20 million people in recovery that miss hyde talks about. so instead of reaching less then 3 million and providing services, we make inroads into the 22-and-a-half million that still need that. our message isn't resonating with multiple groups and so as a field, i think we want to look at
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our message and i think to have that universal language is going to mean that we can't view non-traditional groups as still target populations, if you will, from a deficit perspective. but then we begin to view them as key informants, that they have valuable information that can add to this discussion. and until we begin to do that, it's our, our whole efforts are going to be based around self-serving. we need this particular language to protect our funding stream, we need this particular language to add value to the work that we do versus our primary purpose is to provide the services and the help for people that are struggling with substance abuse or addiction and any of the other issues that they present to us with. well we need the language whereby i can recognize where i need to do additional work and it's not going to be, belittling me or diminishing my worth, but that i can pick up the
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pieces and move forward again in that path to recovery because i think one of the things that we learned early on with the recovery-oriented system of care notion, was that particularly thomas kirk's model in connecticut is that the person is considered to be in recovery the second they have that aha moment. that they realize that they need treatment for their illness and, and from then on they still consider themselves in, in recovery. would that work, i mean in other sectors? i think that, i think that that's very, very important and one of the things i want to say is that, in terms of the development of the recovery or system of care, the focus on language has not been something that i've seen. and i think that everything we do, if we're, if we're doing a conference, whatever we do, there needs to be a component in there on language. we really need to push this because it's,

January 11, 2011 5:30am-6:00am PST

TOPIC FREQUENCY Daphne 6, Voices Of Recovery 5, John 5, Carlos 2, Dvd 2, National Alcohol And Drug Addiction Recovery Month 2, Us Department Of Health And Human Services 2, U.s. Department Of Health And Human Services 2, Samhsa 2, Stories Have Power 1, Powerpoint 1, Wellstone Mental Health Parity Act 1, National Healthcare Reform 1, World Health Movement 1, Maryland 1, Connecticut 1, Road 1, Rfp 1, Michele Monroe 1, Bill White 1
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